"now that I have some time to think…"

emergency rooms

Note: I’m starting this only because a friend that I like and respect very much invited me to be part of the club. And also because as a blogger, I’ve discovered a creative kick in the pants can be very helpful at times. Also, I am going to call this DAY 5, even though it is my first contribution, just so I don’t feel hopelessly behind for the next month.

Just like there was no manual for living my through my 30’s and raising small children, I have longed at times for the manual that would guide me through the difficulties of being a parent to my parents.

My mom is now 92, has dementia, can barely converse with me or anyone else, is incontinent, is hard of hearing, and requires nearly constant supervision. She also has a fragile immune system and just this Sunday it was compromised by something, probably an infection of her lungs. As the only child living in the vicinity, I’ve been on call for 4 years now and once I arrived at her board and care home on Sunday, I could see her labored breathing was going to land us in the emergency room.

I’m not sure if it is worse to be attending someone in the emergency room or to be the actual sick person. Mom was agitated for the two hours we waited to get into a room, which meant she would rock back and forth and jabber incoherently and loudly at times while I would try to calm her and get her to stop.

I’m far beyond being embarrassed by this behavior or worried about the reaction of others. They can move if they don’t like it. Hell, I don’t like it, but not liking it isn’t going to change anything. And here’s where I struggle. To all those waiting sick folk, I appeared to be a patient, attentive, loving son. I comfort her and make silly jokes and do anything to break the cycle of moaning and tension that seems to seize her like a wave that will slowly, and only temporarily, recede. I’m sure they look at me and think, “He’s a good son.”

But I’m not. I hate all of this. I hate the constant, seemingly useless visits I make to her every day, the disturbing emergencies, and even the routine doctor’s visit that usually results in a three-hour commitment. I know that none of my efforts or the doctor’s efforts will improve the quality of her life. Every time I leave her I feel sad and depressed. I’m long past the point where I can tell if I’m sad for her or for me. That’s why I feel like a fraud. I told my wife once that everything I was doing was actually “remorse insurance” for myself—a desire that when she passes I could honestly feel that I had done everything possible to make her last years, if not joyful, at least comfortable.

It seems to me that the true good sons out there have hearts that are much more full of love than mine is. My maddeningly detailed, obsessive, neat freak of a mother left long ago, and I’m now caring for what is left. I desperately want it to be over. I hate myself for saying it, but there it is.

So, it ends up that four hours after I posted my previous piece on the pitfalls of hypochondria, I ended up in the emergency room with chest pains. It was the perfect storm of chest tightness, occasional pain, a raised level of blood pressure, with a touch of vertigo thrown in that pushed me to my 6% threshold of uncertainty and led me to ignore my own certain wisdom and call the Kaiser “advice nurse.”

Once I got on the line with her, she prepared me for the 150 questions she was about to ask me, but I already knew there was only one that was important: “Are you experiencing chest pain?” The rest of the questions were all relevant but unrelated to my immediate future. I was going to the emergency room.

9 PM on the Tuesday night after the Memorial Day weekend and it was SRO in Kaiser emergency, and a lot of these people looked profoundly uncomfortable. In fact, just being around them made me feel more sick than when I had come in. “Chest pain” used to get you right in the door and into a room, but once they established I was stable, I was sent back out to the waiting area. In fact, I half expected one of the nurses to come out and look at my chart and yell at me, “Your pain level is a 2?! You call that pain?! I’ll show you pain, mister!! Man up and come back when it actually hurts!”

Sitting, watching the waiting room slowly empty out until almost midnight began to re-define the entire concept of an “emergency” for me. Once, my name was finally called, I was ushered into a very nice, private observation room where the hospital protocols kicked in and in short order blood was drawn, my chest was x-rayed, and a series of nurses and doctors stopped by to ask me the same, exact questions, over and over again.

It took until 4 AM for them to decide that I was going to spend the night, although that ship had clearly already passed, and that I was going to stay with them until I got a cardiac stress-echocardiogram done, hopefully in the morning.

Somehow the word “hopefully” got past me. My weary and long-suffering wife left me to go home, and I passed out, finding it easy to follow their orders to not eat or drink anything before it was time for the test. By mid-afternoon, when they decided they could starve me no longer, they broke the bad news that there were no openings for the procedure and I would have to be admitted to the hospital to spend yet another night eating hospital food and watching re-runs of Law and Order SVU.

Around 9:30 PM a bed finally opened up in the hospital, and I was transferred out of my fairly comfortable private digs to a regular room, a room that came complete with a roommate. After ten minutes in the room with him, I became convinced that the only reason the bed had become available was that the previous occupant had begged to be removed, offering to sleep in a closet or to be taken off life support—anything to get away from this guy. A nurse came in to ask me my list of questions again and then threw in a new one. “Do you ever have thoughts of harming yourself?” she asked. “Not until just recently,” I deadpanned.

He was in pretty bad shape and hard of hearing so the nurses had to repeat everything they told him, loudly, and he talked loudly in return. And he loved to talk. Every nurse’s visit prompted a new story about his wretched physical condition or his adventurous life. He had been a musician his whole life and owned hundreds of musical instruments, had traveled the world, and spoke lovingly of his wife. He veered horribly close to insulting both a Hispanic and Pilipino nurse and somehow managed to re-engage them, turn on the charm, and became nothing but grateful for their help.

I was almost starting to like him somewhere around 11:30 PM when he suddenly began trying to cough up a lung. He hacked and spat and swore and then started all over again. In deference to me, he went into the bathroom to hock up the other lung, but it was impossible. I could hear everything. I decided to give up on sleep for the night as he settled in to watch some late-night TV which turned out to be the perfect tonic. Before I knew it, I was sound asleep.

The new day brought an introduction to new modern miracles of medicine. By 7:30 AM I was being whisked away for a 4-hour chemical stress echocardiogram. This involves having pictures of your heart taken at rest to create a baseline and then injecting you with chemicals which stress your heart so they can take more pictures to see if your heart is functioning efficiently. It seemed somewhat counterintuitive to me to mess with such chemicals, but since I was not feeling the whole treadmill thing, I went for the drugs.

When I was ready for them, I was taken into a room with a treadmill and lots of monitoring equipment. I was told that I was going to get a “lexi-walk” which was a combination of actually getting me started on the treadmill and then administering the drugs that would give me the jolt. I started my stroll on the treadmill, but couldn’t get the term “lexi-walk” out of my head. I’m sure it was my sleep-deprived state, but it kept conjuring two competing images in my brain. In one, I was strolling down the beach with an adoring young thing named Lexi on my arm, and in the other I was being forced to walk someone’s annoying poodle, whose full name was actually Alexandrika. The images faded quickly when the nurse pumped two injections into my IV and suddenly I felt like I was running a marathon–badly.

After more pictures, it was back to the room. My roommie had vacated temporarily, and my nurse was kind enough to have the nutritionist come in and let me make a special order for my lunch. Oooh, the salmon sounds good and of course I want the mashed potatoes and gravy, and broccoli–not those nasty canned green beans from the night before. How nice, I thought. Personalized service! Peace and quiet!

Within the hour, my lunch arrived: chicken, undercooked carrots, and a bread roll made from sawdust (gluten free, I’m sure).

The only thing remaining, besides getting over my disappointment over lunch, was the visit from a doctor to tell me the results. He was effusive. “A model heart! Your heart sets the gold standard for how we’d like these tests to come out! Yeah, we have no idea what was causing your pain or discomfort, but you seem to be feeling better, so you are good to go!!”

40 hours. 40 hours to hear that despite all of the symptoms and a bucket load of worry, I was just fine. Better than fine. A model that other 61-year-olds should aspire to. It almost made me wish that nurse had come out and yelled at me 40 hours earlier. “Call that pain?! You come in hear and bother us with a level 2 pain complaint?! You don’t know the meaning of pain! You ain’t even coughin’ up a lung like that poor old guy in 5011B. Now, that’s an emergency!”